The Real Cost of Patient Non-Adherence

It is estimated that as many as 10% of all hospital admissions and 23% of
long-term elder care admissions in the United States are a consequence of
failed patient adherence.

It is estimated that as many as 10% of all hospital admissions and 23% of long-term elder care admissions in the United States are a consequence of failed patient adherence. Beyond the direct burden on health care systems there are other significant cost impacts of non-adherence:

Medication non-compliance costs the US alone as much as 100 billion dollars and 125,000 lives every year.
Lost revenue for the US pharmaceutical industry is as much as $30 billion annually.
Up to 70% of all prescriptions are never consumed and 20% of all new drug prescriptions are never filled the first time.
On average non-compliance is estimated at 40-50% and for some diseases, adherence rates are as low as 10-20%.

It is known that the patients health beliefs, the quality of doctor-patient communication and the quality of the information patients receive are important factors for patient adherence to treatment. However, despite their efforts to improve adherence using methods addressing these issues, healthcare stakeholders have been unable to effect significant change.

Some adherence solutions rely on reminder systems to encourage patients to follow their prescribed regimen. Older reminder-system solutions, including providing detailed instructions from medical practitioners, take-home pill calendars or special pill packaging, have had only limited success.

A new inter-disciplinary methodology has been developed by MEMOTEXT, a Canadian provider of telecommunication-based adherence programs, that are adaptable to different treatment regimes, quickly scalable, and cost effective. Using psychographic screening, patient-centered communication, education and advanced technologies geared to patients needs, MEMOTEXT aims to provide personalized and effective support that improves adherence.

The company recently partnered with BioGen Idec Canada, a subsidiary of Biogen Idec Inc., makers of the injection AVONEX (interferon beta-1a), to help MS patients remember to take their medicine. The program, which is named AVOTALK, is a free interactive telephone education, reminder and emotional support service for patients who are prescribed AVONEX and choose to participate.

AVOTALK gives patients the option of receiving text messages sent directly to their cell phone or pre-recorded calls delivered to their landline at predetermined times, reminding them to take their prescribed medicine. AVOTALK subscribers who have questions or concerns can opt to speak with a live nurse when they receive their reminder call. There is also a snooze feature whereby the system calls back at pre-determined intervals if the first call is not picked up. In addition, patients can register to receive short weekly motivational and educational messages.

Telephone based adherence programs have proven efficacy. In a study conducted by United Healthcare of North Carolina, patients with cardiovascular disease relying on a telephone-based reminder system generated 40% fewer inpatient admissions and a reduction in emergency department visits by 73%. And a study by University of Iowa researchers concluded that a telephone-based system was a critical factor leading to an increase in the number of cardiology patients who achieved their target LDL levels.

Baby boomers know the price of non-adherence. As they struggle to care for ailing parents with Alzheimers, MS, Parkinsons, Diabetes, Arthritis and other debilitating diseases, they live with constant worry. The problem of non-adherence is an early wake-up call for an aging generation who hope they will be less of a drain on their own children down the road. While the sadness that aging and disease bring are inevitable, the stress on patients and families, the burden on public and private health care systems and the cost to the pharmaceutical industry can be minimized by embracing adherence as a discipline rather than a problem that can be addressed with a one-size fits all solution.